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Biomedical subjects

P Germaud

Publications and source records attributed to P Germaud.

48 records · Page 3Linked to original sources
PubMed1987

[Bacteriological aspects of 64 cases of severe pneumonia seen in a respiratory intensive care unit].

We report on the bacterial aspects of 64 cases of severe pneumonia in an intensive care over a two year period, excluding cases occurring during artificial ventilation. In all the cases, the grave respiratory and haemodynamic signs, the blood gas and radiological findings justified admission of these patients to an intensive care unit. Specimens for bacteriology, virology and parasitology enabled a precise microbiological diagnosis 43 times (63%); in 44% of these diagnosis the possibility of the protected specimens (trans-tracheal, protected brushing) were confirmed by another specimen (pleural or blood). The germs identified were: Streptococcus pneumoniae (13), Staphylococcus aureus (9), Haemophilus influenzae (6), other gram negatives (12), Mycoplasma pneumoniae (1), Koch's bacillus (1), Aspergillus fumigatus, Cytomegalovirus, Myxovirus, Pneumocystis carinii (5). Twenty eight patients died of whom eight had marrow failure following chemotherapy; amongst the non-leukopenic patients an analysis of the records allowed certain presumptions as to the causative organism according to the patients mode of referral and immune state. The prognosis of these pneumonias remains serious in spite of improved bacteriological diagnosis, above all in the elderly, poorly nourished or with marrow aplasia.

Adolescent↗
PubMed1985

Reliability of the bronchoscopic protected catheter brush in intubated and ventilated patients.

The reliability of a bronchoscopic protected catheter brush (BPCB) in the diagnosis of lower respiratory tract infection was studied in 17 intubated and ventilated patients, including seven patients free from such infection (group 1) and ten patients with suspected infection (group 2). A first sample was obtained in the lower trachea by aspiration through the fiberoptic bronchoscope and a second in a distal bronchus by the BPCB procedure. In group 1, all BPCB cultures were sterile, although lower tracheal cultures yielded two or more bacterial species, showing that uncontaminated specimens can be obtained by the BPCB procedure. In three patients of group 2, BPCB cultures remained sterile as a nonbacterial pulmonary disease was certified by open lung biopsy. In seven patients from group 2, BPCB cultures yielded all of the organisms isolated simultaneously by reference methods (ie, cultures of blood or pleural fluid, serologic tests, and open lung biopsy). In two of these patients, contamination of the BPCB specimens was ascertained by the reference method bacterial results. In this study the BPCB procedure was able to obtain uncontaminated specimens in intubated and ventilated patients and was mainly accurate in identifying the bacterial etiologic agents of lower respiratory tract infections.

Adult↗
PubMed1982

[Pulmonary infection with Pasteurella multocida in an immuno-deficient patient (author's transl)].

A seventy-seven-year-old woman, under intermittent treatment with chlorambucil for chronic lymphocytic leukemia, developed acute pneumonia (diffuse interstitial pneumonitis) due to Pasteurella multocida. No direct traumatism had been caused by her cat. Bacteriologic study material was obtained by guided transtracheal distal bronchial brushing and washing. Therapy with tetracyclin was rapidly successful. Pasteurella multocida is an opportunistic organism which can be responsible for severe infections in high-risk patients.

Aged↗
PubMed1982

[Comparative study of the bacteriologic value of samples taken by transtracheal aspiration or fiberoptic bronchoscopy].

To evaluate two methods of obtaining lower respiratory tract secretions, fiberoptic bronchoscopy (FB) and transtracheal aspiration (TA) were performed in ten patients. FB used an open-end brush-in catheter. TA was performed as described by Pecora. TA gave significantly better sensitivity and specificity (3/5 and O false positive results respectively) than FB (2/5 and 5 false positive results). TA gives specimens which reflect the bacterial flora of the lung more reliably than those taken during FB.

Biopsy, Needle↗
PubMed1982

[Pulmonary fibrosis in ankylosing spondylitis. Five new cases (author's transl)].

The most common thoracic finding in ankylosing spondylitis (AS) is ankylosis of the costovertebral joints with severe limitation of chest expansion inducing a restrictive syndrome pleural and pulmonary fibrosis can occur during the course of the disease. One-hundred record of patients with AS were reviewed. Five had pleuro-pulmonary involvement. This always included pachypleuritis, usually apical. Roentgenographic pulmonary changes were infiltrates or fibrobullous lesions. Pulmonary function tests showed restriction in four cases, obstruction in one case, and a decreased diffusing capacity in all five cases.

Adult↗
PubMed1982

Guided transtracheal distal pulmonary brushing-washing: diagnosing acute pneumonia in high-risk patients.

Transtracheal brushing-washing of distal pulmonary lesions was performed in 20 patients. Specimens were obtained by brushing and washing through a catheter placed in the pulmonary lesion with the aid of a guide. In nine patients pathogenic organisms were isolated. In the other 11 patients infectious studies of the specimens were negative, five of the patients (true-negatives) showing no infection and six (false-negatives) showing infection. Serious complications were uncommon, but one patient, who had diffuse intravascular coagulation, died. This procedure seems to represent an advance over transtracheal aspiration and is an effective alternative to such invasive methods are transthoracic lung aspiration and pulmonary biopsy.

Adult↗
PubMed1982

[Complementary studies in acute bronchopulmonary infections except tuberculosis].

Development of a strategy for the investigation of pulmonary infectious disease is aimed at identifying the organism responsible for the infection in order to prescribe the appropriate antibiotic therapy. Factors involved in the choice of a method are the underlying condition (healthy, high risk or immunodepressed subject), the type of infection (primary, secondary), the technical abilities of the medical and bacteriological team and finally the value of the different techniques of isolation. The latter must provide a specimen which is not contaminated by the oropharyngeal flora. Their reliability involves definition of a reference method which can be used to test the other techniques in comparison, and requires comparison of the bacteriological results obtained with clinical and radiological data as well as the results of the resultant therapeutic decision. Indirect methods of investigation (blood cultures, serological studies) are relatively unfruitful. Criteria of value of direct methods of investigation are defined and applied to each method (expectoration, transtracheal aspiration, bronchial fibroscopy, transparietal puncture). On the basis of data in the literature and their own results, the authors undertake an analytical then comparative (in a given patient) study of the different methods, and identify their indications.

Biopsy↗
PubMedDate not supplied

[Lung infection and acute adult respiratory distress syndrome during surgical resuscitation].

Non cardiogenic pulmonary edema (PE) is frequently observed during the postoperative period. 56 patients with postoperative PE were divided into two groups: ARDS, acute respiratory distress syndrom and NHPE, non hemodynamic PE. The incidence of primary pulmonary infection and pulmonary superinfection were investigated. Both groups were not different except for the level of PaO2 lower in ARDS. Mortality was higher in ARDS (80%) than in NHPE (42%). Pulmonary primary infection and superinfection were respectively observed in 33 and 10%, and 23 and 15% of ARDS and NHPE. Blood cultures were more frequently positive during abdominal sepsis than during pneumonia. Viral etiology was thrice noted in 13 pneumonitis. Value of diagnostic methods for respiratory infections is discussed.

Acute Disease↗